Brochure

Asthma & Complementary Therapies

A complementary therapy is any healing practice that is not considered to be part of conventional (mainstream) medicine. Complementary therapies, however, may be used alongside conventional care. This guide outlines the use of complementary therapies for those living with asthma.

What are complementary therapies?

A complementary therapy is any healing practice that is not considered to be part of conventional (mainstream) medicine. Complementary therapies, however, may be used alongside conventional care.

Complementary therapies may be based on historical or cultural traditions, rather than on scientific evidence. They include treatments, such as herbs and chiropractic therapy, as well as philosophies such as Ayurveda and Traditional Chinese Medicine (TCM).

Complementary therapies may also be called alternative therapies.

Why use complementary therapies?

Over the past few years, people have become more aware of complementary therapies and their use for treating various medical conditions, such as asthma. There are many reasons why some people choose to use complementary therapies. For example, they:

may want to reduce the amount of medicines they use

may prefer to use a “natural” alternative

may be disillusioned with the approach of Western medicine

have heard from others that a particular complementary therapy works well for their condition

feel that using complementary therapies gives them more control over their treatment.

If you are interested in using a complementary therapy for treating your asthma, it’s best that you base your decision on correct information, including the therapy’s potential risks, as well as its benefits.

It is also recommended you get an informed, objective opinion from your health professional.

What is the evidence that complementary therapies might help asthma?

Unlike the conventional medicines your doctor prescribes for you, there is less information available on complementary therapies including how well they work and how safe they are.

The main reason for this is that unlike pharmaceutical companies who need to do high quality clinical research to have their medicine approved by the Australian Government, complementary therapies do not need government approval before they can be used for asthma or other conditions.

This means that complementary therapies lack this high quality research to show which ones are generally useful in improving asthma symptoms and lung function.

However, as more people choose to use complementary therapies, health professionals are beginning to know more about these therapies and, therefore, increase their understanding of such treatments.

In this brochure you will find information on certain complementary therapies and their benefit on asthma control. Only complementary therapies that had high-quality research information have been included in this brochure. By high-quality research we mean published studies that are systematic reviews, meta-analyses and controlled studies.

Helpful resources have also been listed in this brochure.

Can complementary therapies cause harm?

Any treatment, conventional or complementary, has the potential to help as well as harm.

Stopping a treatment that works and switching to one that you aren’t sure will work is risky. That’s why it is best to try out any new treatment with the advice of your doctor.

Despite the common opinion that “natural therapies” or “herbal remedies” are relatively safe, side effects may still happen, including asthma symptoms and allergic reactions.

People who are more prone to suffer from allergies seem to be at higher risk.

Some complementary therapies that can cause asthma symptoms are echinacea, bee pollen or royal jelly (propolis), garlic and products containing aspirin.

The evidence summary table shows you which therapies have known side effects, and what these side effects are.

Why should I consult a health professional about complementary therapies?

Openly discussing your asthma treatment choices with your healthcare professional will help you to effectively manage your asthma. If you would like to try a complementary therapy, talk to your doctor first about how you’d like to improve your asthma, and how you can measure whether the therapy is helping.

Your doctor can help you by checking whether the complementary therapy has improved your asthma. This is done by reviewing your asthma before, during, and after the use of the therapy, by checking:

how often you have asthma symptoms

how severe your symptoms are

how much medicine you use to get your symptoms under control

how well your lungs are working by doing breathing tests.

Your doctor can also help you to get the best out of a complementary therapy by providing you information on:

possible interactions with medicines you are taking

the therapies that have proven health benefits for asthma

any complementary therapies that may potentially worsen your asthma, or cause allergic reactions.

Finally, your doctor may also check whether you have any other changes in your overall wellbeing after using a complementary medicine.

As with any asthma treatment, it is wise to try a complementary therapy for a set period. After this time its benefit can be checked and you can make a decision to stop or continue the therapy

It is also very important that you do not stop taking your regular asthma preventer medicines without discussing this first with your doctor.

Stopping preventer medications suddenly can sometimes be dangerous for people with asthma, as it may result in more frequent severe asthma attacks.

Regulation of complementary therapists and therapies

Therapists

In Australia, health professionals (such as medical doctors, pharmacists, osteopaths, chiropractors, and Chinese Medicine therapists), are registered with the Australian Health Practitioners Regulation Agency (AHPRA; ahpra.gov.au). There are no regulations for the other complementary therapists.

While naturopaths and herbalists cannot register with AHPRA and are not government-regulated professions, they can register with the Australian Register of Naturopaths and Herbalists (ARONAH; aronah.org). ARONAH sets minimum standards of practice for naturopaths and herbalists.

When choosing a suitable complementary therapist, you may find asking these questions helpful:

what experience has the therapist had in treating people with asthma?

do they have professional registration, and with whom?

what exactly is the therapy they will treat you with?

how long will you need to have the treatment for before you see any benefits?

what is the cost per session, and what is the likely total cost?

what evidence is there that the treatment works – is it based on other people’s experiences or on good-quality research?

what are the risks of having the treatment?

am I being asked to stop my usual medicines while being treated?

Therapies

Medicines used in complementary therapies are subject to Australian law. Most complementary medicines are ‘listed’ (AUST L) products with the Therapeutic Goods Administration (TGA) – the government arm that regulates medicines in Australia (tga.gov.au).

Keep in mind that listed products do not get assessed for how well they work – unlike conventional medicines (also known as registered (AUST R) products). However, these products do get checked to make sure those that are likely to have dangerous side effects are not listed.

Because listed products are not assessed for how well they work, their claims can only be limited to:

assisting with a condition

maintaining health

reducing the risk of non-serious conditions.

Listed products cannot claim to treat any condition.

About the evidence summary table

A group of expert health professionals with a special interest in complementary therapies and asthma reviewed good-quality research information to put together this brochure.

They looked for therapies that:

improved asthma symptoms

helped to reduce the amount of reliever medication needed

improved lung function (breathing capacity)

improved overall feeling of wellbeing (Quality of Life).

An assessment of the effect of each therapy was made, in addition to the quality of the published evidence. By quality of the published evidence we mean both the quality of the methodology and the strength of the evidence available.

This information is summarised in the evidence table on the following pages. How well each therapy works has been rated using a scale.

This table was updated in March 2012. Keep in mind that complementary therapy is a constantly evolving area, and new information is regularly becoming available. If you would like to know more about the research information reviewed in the summary table, you can find them listed on the National Asthma Council Australia website.

For more general information on complementary therapies, talk to your doctor or see the list of resources provided at the end of this brochure.

Please note: The evidence presented in the table does not demonstrate the degree to which the therapy may have had an effect on asthma, only that there was an effect. It is also acknowledged that there are many complementary and alternative medicines used in the treatment of asthma; however, we were only able to include those treatments evaluated in controlled clinical studies that have been published.

Evidence Summary Table

The information in this table looks at the following therapies:

Nutritional and Dietary supplements

Diet Restriction

Herbal Medicines

Indian Herbs

Other Therapies

Homeopathy

Mind-body Medicine

Manipulative/body based therapy

Considered therapies where no controlled studies were available.

To view the evidence summary table, please download the PDF brochure.

Asthma and food allergies

Unfortunately, there are no high-quality studies that look at the benefit of eliminating certain foods (like dairy and wheat) on asthma. For this reason you need to keep in mind that:

asthma and food allergy may exist together, even though they may not be related

If you suspect that you or your child has food allergies, a test that measures certain allergy antibodies (IgE) will need to be done to confirm that allergies exist. An immunology specialist (with a referral from your GP) can perform the test. If you are considering excluding certain foods from your or your child’s diet, it should only be done for a short period under the supervision of your doctor and dietician (or nutritionist).

*Sudden life-threatening allergic reaction; signs of anaphylaxis include sudden signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing.

Complementary (unconventional) tests

Complementary approaches include more than just healing practices and treatments – they also include tests, such as those used to diagnose and assess a condition.

Allergic diseases such as asthma can be accurately diagnosed and treated using scientifically proven tests like spirometry (see the brochure “Asthma and Lung Function Tests” via our website nationalasthma.org.au). However a number of scientifically unproven tests are also becoming popular. Research has shown that these tests, such as vega testing, iridology, kinesiology, cytotoxic food testing and IgG (food allergy) testing, are not reliable. They are also not regulated in Australia/New Zealand or currently covered by Medicare.

The Australasian Society for Clinical Immunology and Allergy (ASCIA- the expert health organisation for immunological and allergic conditions) advises against using these tests to diagnose conditions or guide treatment. British, American and European allergy and immunology organisations also give the same advice.

You should be cautious about accepting the results of such tests for diagnosis and treatment without first discussing them with your doctor.

For Health Professionals

Acknowledgments

Developed by the National Asthma Council Australia in consultation with an expert panel of respiratory and allergy clinicians with a special interest in allergies and asthma.

Supported through funding from the Australian Government Department of Health.

Recommended Citation

National Asthma Council Australia. Asthma & Complementary Therapies: A guide to the use of complementary therapies for those living with asthma. Melbourne. National Asthma Council Australia, 2012.

Correction (May 2013)

Please note a production error has been corrected in this online version. The overall ranking (symbol) for Qigong should be square as seen below:

Disclaimer

Although all care has been taken, this brochure is only a general guide; it is not a substitute for individual medical advice/treatment. The National Asthma Council Australia expressly disclaims all responsibility (including negligence) for any loss, damage or personal injury resulting from reliance on the information contained.

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